Mesenchymal stromal cell infusion to treat steroid-refractory acute GvHD III/IV after hematopoietic stem cell transplantation.

Acute GvHD (aGvHD) is a life-threatening complication of hematopoietic stem cell transplantation. Frontline therapy for aGvHD consists of corticosteroid administration. However, ∼25% of the patients have a steroid-refractory disease, a sign of poor prognosis. An alternative therapy for steroid-refractory aGvHD is infusion of mesenchymal stromal cells (MSCs). Herein, we report the results of 46 patients treated with MSC infusion as salvage therapy for steroid-refractory aGvHD III/IV (78% grade IV). Patients received a median cumulative dose of MSCs of 6.81 × 106/kg (range, 0.98-29.78 × 106/kg) in a median of 3 infusions (range, 1-7). Median time between the onset of aGvHD and the first MSC infusion was 25.5 days (range, 6-153). Of the patients, 50% (23/46) presented clinical improvement. Of these, 3 patients (13%) had complete response, 14 (61%) had partial response and 6 (26%) had transient partial response. The estimated probability of survival at 2s year was 17.4%. Only 2 patients (4.3%) presented acute transient side effects (nausea/vomiting and blurred vision) during cell infusion. No patient had late or severe side effects because of MSC infusion. These results suggest that this therapeutic modality is safe and should be considered for steroid-refractory aGvHD, especially in countries where other second-line agents are less available.

Estudo comparativo dos efeitos do extrato de Ginkgo biloba L. e Panax ginseng C.A. Meyer na reprodução de ratos machos e fêmeas Wistar / Comparative study of effects of Ginkgo biloba L. and Panax ginseng C.A. Meyer extract on the reproduction of Wistar male and female rats

Ginkgo biloba e Panax ginseng são plantas utilizadas na medicina tradicional. O objetivo do estudo foi avaliar a histologia gonadal de ratos machos e fêmeas Wistar submetidos aos tratamentos com o extrato de G. biloba (120 mg kg-1) ou P. ginseng (200 mg kg-1), e avaliar os parâmetros reprodutivos e fetais das ratas tratadas com as plantas. O grupo controle recebeu solução fisiológica 0,9%. Os tratamentos foram efetuados por via oral através de gavage, duas vezes ao dia, durante quinze dias consecutivos. Após este período, machos (n=18) e fêmeas (n=18) foram sacrificados e as gônadas coletadas, pesadas e processadas para avaliação microscópica. Outras fêmeas (n=18) foram acasaladas com machos não tratados para avaliação da fertilidade e produtos da gestação. Os resultados indicaram que o peso dos órgãos reprodutivos masculino e feminino não foi afetado pelos tratamentos. A estrutura gonadal dos machos e fêmeas mostrou o mesmo padrão histológico nos três grupos experimentais. O tratamento materno pré-gestacional com os extratos não promoveu alterações no desempenho reprodutivo das matrizes e nos parâmetros fetais. Concluiu-se que o extrato de P. ginseng ou G. biloba não causou toxicidade reprodutiva em ratos machos e fêmeas.

Ginkgo biloba and Panax ginseng are plants used in the traditional medicine. The aim of study was to analyse the gonadal histology of the Wistar male and female rats submitted to the treatments with extract of G. biloba (120 mg kg-1) or P. ginseng (200 mg kg-1), and to evaluate the reproductive and fetal parameters of female rats treated with the plants. The control group received physiological solution 0.9%. The treatments were administered by oral gavage, twice/day, during fifteen consecutive days. After this period, male (n=18) and female rats (n=18) were sacrificed and the gonads collected, weighed and processed for microscopic evaluation. Another females (n=18) were matted with not treated males for evaluation of fertility and pregnancy outcome. The results indicated that the male and feminine reproductive organs weight was not affected by treatments. The gonadal structure of male and female rats showed same histologic pattern in the three experimental groups. The pre-gestational treatment with the extracts not promoted alterations in the reproductive performance of dams and in the fetal parameters. It was concluded that the extract of P. ginseng or G. biloba not presented reproductive toxicity in the male and female rats.

Pulmonary amoebiasis presenting as superior vena cava syndrome.

Pulmonary amoebiasis without liver involvement occurs sporadically as a result of haematogenous spread from a primary site, the colon. The case history is presented of a patient who developed superior vena cava syndrome due to a pulmonary amoebic abscess without liver involvement. He was initially suspected of having a neoplasm but a combination of tests including histological examination of the H&E stained excised tissue, immunofluorescence using anti-Entamoeba histolytica antibodies, and serology confirmed the diagnosis of amoebiasis. To our knowledge this is the first description of pulmonary amoebiasis presenting as superior vena cava syndrome.

Teste da estimulacao sonica em gestantes hipertensas sob tratamento com beta-bloqueador (Pindolol) / Sound stimulation test during treatment of maternal hypertension with beta-adrenoceptor blockers (Pindolol)

Estudo do Teste da Estimulacao Sonica (TES) efetuado em 46 gestantes tratadas com Pindolol e Levomepromazina (9 mg/dia) divididas em tres grupos, I, II e III, respectivamente com 10, 20 e 30 mg/dia de Pindolol. Todas foram submetidas a operacao cesariana antes do inicio das contracoes do trabalho de parto. Para a analise da resposta cardiaca fetal foram consideradas a amplitude e a duracao da cardioaceleracao. Houve diminuicao da resposta cardiaca verificada por estas duas variaveis com o incremento do beta-bloqueador, sem contudo, haver significado estatistico. Todavia, a resposta cardiaca nos tres grupos foi significamente menor quando comparada com a resposta verificada por Zugaib e "col. POT. 19" em 30 gestantes hipertensas tratadas apenas com 9 mg/dia de Levomepromazina.